Provider Demographics
NPI:1972123164
Name:LOCKWOOD, NISHITA VANI (MD)
Entity type:Individual
Prefix:
First Name:NISHITA
Middle Name:VANI
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NISHITA
Other - Middle Name:
Other - Last Name:MAGANTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLZ
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-4973
Practice Address - Country:US
Practice Address - Phone:310-267-8626
Practice Address - Fax:310-267-8679
Is Sole Proprietor?:No
Enumeration Date:2020-04-17
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT77022207L00000X
AZ76311207L00000X
390200000X
CAA200102207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program